Individual provider Active NPI

Eman Yusuf, DDS

  • General Practice Dentistry
  • Waxahachie, TX
National Provider Identifier
1154904944
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38679 Issued in TX
Practice address
1011 N Highway 77 Ste 105
Waxahachie, TX 75165-1798
Phone
(972) 351-9110
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 109778 CA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 38679 TX Primary

Addresses

Primary practice location

1011 N Highway 77 Ste 105
Waxahachie, TX 75165-1798

Mailing address

1011 N Highway 77 Ste 105
Waxahachie, TX 75165-1798
Phone (972) 351-9110

Other practice location 1

1012 E Ennis Ave Ste C
Ennis, TX 75119-4350
Phone (972) 875-2501

Other practice location 2

1559 Pacific Coast Hwy Ste 101
Hermosa Beach, CA 90254-3214
Phone (310) 372-7686

Other practice location 3

6410 Fannin St Ste 310
Houston, TX 77030-3004
Phone (713) 500-5819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524000008 CA Order and Referring Only - DentistPractitioner - Dentist 8527400381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109778CAMDSocial Worker
38679TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Namsheel Dental PLLC General Practice CurrentSince Dec 1, 2024 Accepting new patients
Braces R US PC PastSince Jun 1, 2022 Accepting new patients
Oates and Jefferson Dental Corporation General Practice PastSince Dec 1, 2023 Accepting new patients
Ennis Dental PLLC General Practice PastSince Jun 1, 2022 Accepting new patients

Locations

1011 N Highway 77
Ste 105
Waxahachie, TX 75165
Phone (972) 351-9110

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1154904944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N HIGHWAY 77 STE 105",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651798",
            "telephone_number": "972-351-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N HIGHWAY 77 STE 105",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651798",
            "telephone_number": "972-351-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 E Ennis Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Ennis",
            "state": "TX",
            "postal_code": "751194350",
            "country_code": "US",
            "telephone_number": "972-875-2501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1559 Pacific Coast Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Hermosa Beach",
            "state": "CA",
            "postal_code": "902543214",
            "country_code": "US",
            "telephone_number": "310-372-7686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6410 Fannin St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303004",
            "country_code": "US",
            "telephone_number": "713-500-5819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUF",
        "first_name": "EMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109778",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.